2018 HEDIS Rate Chart by HEDIS - dhs.pa.gov

Domain: Effectiveness of Care Health Plan

Measure Aetna Better

Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania

Gateway Health Geisinger

Health Plan

Health Partners

Plans Keystone First

United

Healthcare UPMC for You

Weighted

Average

Adult BMI Assessment 86.13% 90.51% 93.19% 89.54% 94.56% 93.40% 88.81% 91.97% 95.83% 97.93%

BMI Percentile Documentation, Ages 3-11 69.20% 72.79% 84.94% 72.95% 83.40% 80.17% 82.33% 82.19% 75.86% 78.65%

BMI Percentile Documentation, Ages 12-17 74.59% 75.54% 84.21% 64.07% 80.99% 77.52% 77.34% 83.54% 74.59% 76.30%

BMI Percentile Documentation, Total 70.80% 73.72% 84.67% 69.34% 82.53% 79.25% 80.78% 82.73% 75.42% 77.80%

Counseling for Nutrition, Ages 3-11 65.40% 75.00% 75.68% 64.75% 72.33% 82.64% 79.86% 79.76% 71.98% 74.44%

Counseling for Nutrition, Ages 12-17 68.85% 84.17% 75.00% 59.28% 69.01% 79.07% 78.13% 74.39% 67.21% 71.66%

Counseling for Nutrition, Total 66.42% 78.10% 75.43% 62.53% 71.14% 81.40% 79.32% 77.62% 70.34% 73.42%

Counseling for Physical Activity, Ages 3-11 56.75% 64.34% 68.73% 57.38% 65.22% 61.98% 71.38% 69.64% 66.81% 65.38%

Counseling for Physical Activity, Ages 12-17 65.57% 75.54% 73.03% 57.49% 69.01% 72.09% 74.22% 75.00% 63.11% 68.61%

Counseling for Physical Activity, Total 59.37% 68.13% 73.32% 57.42% 66.58% 65.50% 72.26% 71.78% 65.54% 66.51%

Childhood Immunization Status, Combo 2 70.56% 66.91% 76.89% 72.26% 76.16% 82.24% 79.56% 76.40% 74.45% 76.07%

Immunizations for Adolescents, Combo 1 79.08% 84.67% 85.89% 88.32% 86.37% 88.08% 86.62% 83.94% 85.64% 85.94%

Lead Screening in Children 77.62% 81.75% 75.43% 75.43% 81.75% 82.73% 77.62% 81.51% 86.86% 80.32%

Breast Cancer Screening, Ages 52-74 45.72% 58.04% 63.08% 54.53% 58.91% 63.29% 62.73% 50.88% 57.49% 58.41%

Cervical Cancer Screening (Ages 21-64) 50.36% 59.12% 63.26% 56.45% 60.26% 69.13% 61.56% 57.66% 62.24% 60.82%

Non-Recommended Cervical Cancer Screening in

Adolescent Females (Ages 16-20) 0.91% 2.55% 0.82% 0.91% 2.22% 0.54% 0.42% 0.60% 0.92% 0.91%

Chlamydia Screening in Women, Ages 16 to 20 Years 51.78% 46.12% 53.12% 53.71% 47.18% 74.97% 67.39% 56.64% 47.68% 56.91%

Chlamydia Screening in Women, Ages 21 to 24 Years 62.95% 54.86% 57.32% 63.52% 56.17% 75.53% 73.30% 68.26% 58.88% 64.75%

Appropriate Testing for Children With Pharyngitis 79.69% 77.36% 80.10% 81.24% 84.23% 81.97% 84.24% 83.59% 85.75% 82.92%

Appropriate Treatment for Children With Upper Respiratory

Infection 91.53% 88.62% 90.31% 89.99% 93.59% 95.40% 95.44% 89.62% 87.72% 91.14%

®️2018 HEDIS Rate Chart by HEDIS

Domain: Effectiveness of Care Continued Health Plan

Weighted


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Average

Avoidance of Antibiotic Treatment in Adults with Acute

Bronchitis 38.48% 28.24% 29.74% 37.55% 39.19% 44.64% 35.89% 37.71% 35.46% 36.41%

Use of Spirometry Testing in the Assessment and Diagnosis

of Chronic Obstructive Pulmonary Disease (COPD) 25.34% 26.72% 33.33% 29.46% 30.54% 29.02% 25.35% 31.45% 32.72% 29.59%

Pharmacotherapy Management of COPD Exacerbation

(Systemic Corticosteroids) 83.19% 80.89% 81.04% 72.53% 79.26% 72.67% 77.21% 73.44% 69.78% 74.94%

Pharmacotherapy Management of COPD Exacerbation

(Bronchodilators) 82.15% 87.84% 88.44% 82.04% 85.90% 90.78% 92.53% 81.84% 79.08% 85.19%

Statin Therapy for Patients With Cardiovascular Disease

Received Statin Therapy (Total) 81.08% 70.57% 75.64% 80.72% 82.36% 80.17% 70.38% 79.57% 78.05% 77.70%

Statin Therapy for Patients With Cardiovascular Disease

Statin Adherence 80% (Total) 60.91% 74.92% 80.90% 66.92% 66.74% 68.89% 80.49% 62.57% 68.28% 70.00%

Statin Therapy for Patients With Diabetes Received Statin

Therapy (Total) 63.86% 52.40% 53.10% 64.67% 64.76% 67.25% 50.56% 63.44% 61.84% 60.27%

Statin Therapy for Patients With Diabetes Statin Adherence

80% (Total) 59.13% 75.00% 77.25% 61.57% 62.48% 64.96% 74.17% 59.55% 65.54% 66.39%

Medication Management for People with Asthma (Medication

Compliance 75%), Ages 5 to 64 4 36.16% 56.30% 55.15% 38.02% 47.86% 39.43% 46.73% 37.37% 44.54% 44.46%

Asthma Medication Ratio, Ages 5 to 64 64.13% 62.12% 68.73% 64.54% 68.24% 65.44% 61.81% 60.14% 66.73% 64.46%

Controlling High Blood Pressure, Ages 18 to 85 4 60.83% 68.13% 65.94% 52.31% 70.47% 69.88% 62.77% 65.69% 65.89% 64.35%

Persistence of Beta Blocker Treatment After a Heart Attack,

18 years and older 83.67% 86.42% 91.45% 84.46% 84.92% 79.40% 88.75% 80.17% 85.29% 84.97%

Domain: Effectiveness of Care (Continued) Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

Hemoglobin A1c Screening for People with Diabetes 83.24% 87.10% 86.52% 87.40% 86.13% 89.06% 86.24% 84.91% 89.54% 87.23%

Hemoglobin A1c Poorly Controlled in People with Diabetes1,4 38.86% 36.04% 34.24% 39.87% 32.30% 33.13% 35.49% 37.12% 30.69% 34.69%

Hemoglobin A1c Good Control in People with Diabetes

(<8.0%) 47.95% 52.12% 51.55% 45.61% 55.47% 55.31% 54.39% 52.47% 55.14% 52.87%

Hemoglobin A1c Good Control in People with Diabetes

(<7.0%) 32.60% 38.20% 36.74% 32.36% 38.76% 39.33% 38.93% 37.83% 40.63% 37.83%

Eye Exams for People with Diabetes 43.67% 58.83% 63.21% 55.82% 64.78% 62.66% 55.89% 57.14% 62.06% 58.98%

Medical Attention for Nephropathy 87.52% 89.93% 85.79% 90.59% 89.05% 91.56% 89.22% 88.52% 90.73% 89.63%

Blood Pressure Control (<140/90 mm Hg) 60.61% 75.44% 72.13% 62.04% 82.12% 66.25% 67.00% 70.76% 72.34% 69.20%

Disease Modifying Anti-Rheumatic Drug Therapy in

Rheumatoid Arthritis 77.50% 78.18% 85.10% 76.22% 79.33% 77.02% 70.43% 78.21% 75.83% 76.55%

Use of Imaging Studies for Low Back Pain 66.48% 67.18% 68.90% 69.30% 69.67% 76.66% 79.56% 72.89% 72.82% 72.47%

Antidepressant Medication Management (Effective Acute

Phase Treatment) 48.13% 60.76% 60.58% 46.51% 50.43% 45.39% 56.53% 49.01% 51.40% 51.40%

Antidepressant Medication Management (Effective

Continuation Phase Treatment) 32.48% 51.54% 49.62% 31.97% 36.29% 31.80% 45.33% 34.62% 33.40% 37.15%

Follow-Up Care for Children Prescribed ADHD Medication

(Initiation Phase) 26.32% 29.19% 23.52% 50.24% 39.27% 53.98% 20.36% 55.38% 50.34% 40.45%

Follow-Up Care for Children Prescribed ADHD Medication

(Continuation and Maintenance Phase) 30.40% 35.29% 26.68% 57.87% 37.56% 61.92% 23.36% 63.96% 53.60% 45.21%

Diabetes Screening for People With Schizophrenia or Bipolar

Disorder Who Are Using Antipsychotic Medications, Ages 18-

64

87.44% 89.35% 90.04% 88.14% 89.60% 89.31% 86.05% 86.69% 88.55% 88.12%

Diabetes Monitoring for People With Diabetes and

Schizophrenia, Ages 18-64 68.91% 75.81% 70.55% 71.34% 80.31% 79.61% 76.03% 66.47% 76.25% 74.85%

Cardiovascular Monitoring for People With Cardiovascular

Disease and Schizophrenia, Ages 18-643 NA NA NA 73.68% NA 83.72% 82.61% NA 67.57% 78.07%

Adherence to Antipsychotic Medications for Individuals With

Schizophrenia, Ages 19-64 54.57% 78.26% 69.72% 66.14% 71.77% 59.87% 70.16% 62.79% 70.39% 66.56%

Use of Multiple Concurrent Antipsychotics in Children and

Adolescents (Total) 2.06% 1.37% 1.37% 1.59% 2.13% 0.55% 1.10% 0.53% 1.83% 1.50%

Metabolic Monitoring for Children and Adolescents on

Antipsychotics (Total) 66.62% 69.17% 67.10% 64.10% 72.24% 62.67% 56.68% 60.26% 58.29% 63.08%

Annual Monitoring for Patients on Persistent Medications 85.07% 85.51% 88.10% 87.24% 88.44% 88.89% 86.00% 86.58% 86.63% 87.06%

Domain: Access/Availability of Care Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

Adults' Access to Preventive / Ambulatory Health Services,

Ages 20 to 44 Years 65.92% 82.30% 83.16% 82.28% 83.28% 75.26% 76.61% 71.73% 81.01% 77.84%


Ages 45 to 64 Years 73.49% 87.06% 90.00% 89.24% 88.99% 86.98% 86.47% 79.70% 87.88% 86.09%


Ages 65 Years and Older 69.59% 88.17% 88.42% 88.04% 88.22% 84.53% 82.91% 74.60% 85.15% 82.98%


Total 68.27% 83.96% 85.52% 84.64% 85.27% 79.57% 80.15% 74.28% 83.46% 80.70%

Children's Access to Primary Care Practitioners, Ages 12 to

24 Months 94.64% 95.66% 92.95% 96.96% 97.24% 95.63% 96.18% 94.65% 97.37% 95.98%

Children's Access to Primary Care Practitioners, Ages 25

Months to 6 Years 86.40% 87.27% 84.64% 89.26% 89.70% 88.13% 88.18% 87.40% 90.69% 88.36%


11 Years 90.74% 90.37% 89.69% 93.34% 94.28% 92.60% 93.57% 91.30% 93.23% 92.60%


19 Years 89.49% 90.00% 88.98% 92.03% 93.37% 90.27% 92.67% 91.11% 91.58% 91.46%

Annual Dental Visit, Ages 2 to 20 Years2,4 57.88% 64.30% 65.90% 63.70% 57.85% 66.51% 69.35% 58.81% 58.58% 63.00%

Prenatal Care in First Trimester4 82.00% 85.40% 90.02% 81.51% 86.62% 89.29% 84.91% 84.43% 91.24% 86.56%

Postpartum Care4 58.15% 65.94% 67.88% 66.18% 70.32% 74.45% 64.96% 63.26% 71.78% 67.71%

Domain: Utilization and Relative Resource Use Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

Well-Child Visits in the First 15 Months of Life (6 or more

visits)4 65.69% 75.43% 72.51% 68.37% 74.85% 68.36% 69.10% 74.45% 68.06% 69.90%

Well-Child Visits in the Third, Fourth, Fifth and Sixth Year of

Life4 72.99% 74.70% 82.00% 76.40% 79.86% 82.59% 75.18% 77.13% 77.70% 77.57%

Adolescent Well-Care Visits4 47.93% 65.21% 66.18% 61.56% 60.69% 65.21% 63.99% 62.29% 61.46% 61.98%

Frequency of Selected Procedures Procedures/1,000 Member Months

Bariatric Weight Loss Surgery - 0 to 19 Years, Male 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Bariatric Weight Loss Surgery - 0 to 19 Years, Female 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00





Tonsillectomy - 0 to 9 Years 0.59 0.74 0.88 0.63 0.73 0.66 0.53 0.54 0.76 0.66

Tonsillectomy - 10 to 19 Years 0.27 0.38 0.39 0.30 0.28 0.19 0.20 0.20 0.37 0.28

Hysterectomy, Abdominal - 15 to 44 Years 0.08 0.09 0.11 0.08 0.12 0.09 0.09 0.05 0.09 0.09

Hysterectomy, Abdominal - 45 to 64 Years 0.27 0.29 0.23 0.20 0.27 0.23 0.27 0.24 0.19 0.23

Hysterectomy, Vaginal - 15 to 44 Years 0.12 0.14 0.16 0.12 0.10 0.05 0.06 0.05 0.15 0.10

Hysterectomy, Vaginal - 45 to 64 Years 0.16 0.11 0.20 0.16 0.11 0.13 0.11 0.16 0.14 0.14

Domain: Utilization and Relative Resource Use (Continued) Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

Frequency of Selected Procedures (Continued) Procedures/1,000 Member Months

Cholecystectomy, Closed (Laparoscopic) - 30 to 64 Years,

Male 0.19 0.27 0.25 0.30 0.32 0.16 0.17 0.20 0.36 0.25

Cholecystectomy, Closed (Laparoscopic) - 15 to 44 Years,

Female 0.60 0.94 0.66 0.63 0.76 0.39 0.39 0.44 0.74 0.59

Cholecystectomy, Closed (Laparoscopic) - 45 to 64 Year,s

Female 0.47 0.74 0.71 0.64 0.69 0.35 0.36 0.45 0.63 0.53

Cholecystectomy, Open - 30 to 64 Years, Male 0.02 0.01 0.04 0.02 0.04 0.05 0.02 0.01 0.03 0.03

Cholecystectomy, Open - 15 to 44 Years, Female 0.00 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01 0.01

Cholecystectomy, Open - 45 to 64 Years, Female 0.07 0.04 0.02 0.02 0.03 0.03 0.04 0.01 0.03 0.03

Back Surgery - 20 to 44 Years, Male 0.16 0.27 0.20 0.20 0.33 0.11 0.12 0.14 0.28 0.20

Back Surgery - 20 to 44 Years, Female 0.14 0.18 0.21 0.19 0.26 0.08 0.10 0.15 0.26 0.17

Back Surgery - 45 to 64 Years, Male 0.44 0.81 0.74 0.75 0.79 0.33 0.44 0.51 0.80 0.60

Back Surgery - 45 to 64 Years, Female 0.39 0.56 0.63 0.71 0.64 0.31 0.36 0.49 0.74 0.54

Mastectomies - 15 to 44 Years, Female 0.03 0.05 0.04 0.03 0.03 0.03 0.05 0.02 0.03 0.03

Mastectomies - 45 to 64 Years, Female 0.11 0.09 0.18 0.12 0.12 0.12 0.12 0.15 0.11 0.12

Lumpectomies - 15 to 44 Years, Female 0.10 0.12 0.08 0.11 0.12 0.15 0.14 0.09 0.09 0.11

Lumpectomies - 45 to 64 Years, Female 0.34 0.38 0.32 0.35 0.24 0.44 0.44 0.32 0.29 0.35

Domain: Utilization and Relative Resource Use (Continued) Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

Ambulatory Care, All Ages Visits/1,000 Member Months

Outpatient Visits 275.26 396.63 398.19 371.66 407.67 305.40 314.79 317.53 373.77 346.52

Emergency Department Visits1 66.63 76.68 80.21 80.42 63.59 70.73 64.45 62.75 65.00 68.91

Inpatient Utilization - General Hospital/Acute Care, All Ages Discharges/1,000 Member Months and Average Length of Stay

Total Discharges 5.76 7.14 7.13 7.48 6.17 7.08 8.41 6.65 7.01 7.13

Maternity Discharges 2.25 3.02 3.24 2.49 2.53 2.85 2.73 2.43 2.59 2.65

Surgery Discharges 1.46 1.53 1.59 2.03 1.41 1.80 1.97 1.54 2.06 1.79

Medicine Discharges 2.64 3.41 3.25 3.68 2.90 3.18 4.50 3.32 3.03 3.41

Total Average Length of Stay 4.75 4.21 4.34 4.42 4.12 4.60 4.43 4.72 4.31 4.44

Maternity Average Length of Stay 2.71 2.53 2.81 2.76 2.65 2.82 2.89 2.80 2.64 2.76

Surgery Average Length of Stay 7.31 6.02 6.67 6.77 6.55 7.51 7.38 8.30 6.47 7.04

Medicine Average Length of Stay 4.62 4.48 4.27 3.92 3.87 4.13 3.81 4.10 3.88 4.02

Antibiotic Utilization Prescription Per Member Per Year and Percentage of Antibiotics of Concern

Average Number of Antibiotic Prescriptions PMPY, All Ages 0.86 1.31 0.99 0.94 1.17 0.72 0.87 0.78 1.08 0.94

Percentage of Antibiotics of Concern of Total Antibiotic

Prescriptions, All Ages 39.86% 42.62% 37.05% 37.41% 42.87% 35.45% 35.71% 37.22% 40.30% 38.57%

Domain: Health Plan Descriptive Information Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

Board Certification 45.34% 87.49% 87.49% 56.49% 85.68% 83.08% 85.82% 76.48% 85.50% 72.25%

HealthChoices Enrollment 8.94% 3.84% 8.31% 13.13% 8.14% 10.91% 18.67% 9.88% 18.18% 11.11%

Years in Business 8 5 20 25 5 33 21 8 22

Domain: Effectiveness of Care - 1st year measures Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

Use of Opioids at High Dosage1, 5 77.14 60.05 73.14 73.68 68.30 90.51 114.09 97.26 72.57 84.20

Use of Opioids From Multiple Providers - Multiple

Pharmacies1 , 5 68.23 117.45 56.01 59.27 42.84 57.40 76.54 24.97 224.32 96.11

Use of Opioids From Multiple Providers - Multiple

Prescribers1, 5 194.68 184.29 211.63 241.46 179.26 174.87 184.07 177.10 53.13 163.52

Use of Opioids From Multiple Providers - Multiple Prescribers

and Multiple Pharmacies1,5 31.01 45.56 29.77 34.25 20.84 30.24 38.14 12.48 28.36 30.40

Plan All Cause Readmissions Expected Readmission Rate5 0.17 0.17 0.18 0.20 0.18 0.20 0.21 0.19 0.07 0.13

Plan All Cause Readmissions Observed Readmission

(Num/Dem) 5 10.20% 9.37% 10.67% 16.09% 12.12% 9.63% 17.53% 13.20% 10.26% 12.12%

1 A lower rate indicates better performance for these measures.

2 ADV (ages 2-20) is a P4P measure beginning 2016.

3 NA indicates that the health plan followed the specifications but the denominator was too small (< 30) to report a valid rate.

4 Measures highlighted in yellow are Pay-for-Performance (P4P) measures.

5 Use of Opioids at High Dosage, Use of Opioids from Multiple Providers, Plan All-Cause Readmissions are 1st year measures and will not be reported in 2018.

* Rates in red font are less than the weighted average for the measure and may appear equal to weighted averages due to rounding.

®️2018 Adult CAHPS Rate Chart by Survey Section

Survey Section: Your Health Care in the Last Six Months Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health

Health Partners


United


Weighted

Average

Needed Care Right Away (Usually or Always) 84.55% 86.28% 89.60% 87.36% 83.46% 85.98% 84.03% 82.81% 92.12% 86.75%

Appointment for Routine Care When Needed (Usually or

Always) 78.41% 84.59% 85.76% 84.08% 81.74% 80.81% 80.25% 85.58% 84.57% 83.30%

Talk About Preventing Illness (Yes) 71.50% 74.93% 74.43% 74.84% 72.80% 76.65% 76.17% 75.00% 67.48% 73.43%

Talk About the Reasons You Might Want to Take a Medicine

(Yes) 90.82% 93.72% 89.94% 94.87% 96.18% 85.71% 88.14% 92.92% 94.95% 92.47%

Talk About the Reasons You Might Not Want to Take a

Medicine (Yes) 67.68% 72.77% 60.00% 70.19% 64.89% 63.10% 59.83% 69.91% 69.77% 66.92%

Asked About Best Choice for You Regarding Medications

(Yes) 76.53% 80.93% 78.09% 83.85% 78.46% 77.38% 75.86% 79.65% 75.46% 78.60%

Satisfaction with Health Care (Rating of 8 to 10) 66.67% 77.31% 74.05% 72.82% 74.79% 75.13% 76.37% 75.97% 77.64% 74.94%

Getting Care You Need (Usually or Always) 84.04% 90.45% 83.91% 85.21% 89.50% 87.18% 85.65% 87.55% 88.48% 87.03%

In the last 6 months, did you get care from a dentist's office

or dental clinic? Yes 35.64% 36.00% 41.04% 34.25% 46.94% 39.44% 44.08% 38.89% 36.52% 38.90%

In the last 6 months, did you get care from a dentist's office

or dental clinic? No 64.36% 64.00% 58.96% 65.75% 53.06% 60.56% 55.92% 61.11% 63.48% 61.10%

In the last 6 months, how many times did you go to a

dentist's office or dental clinic? None 0.00% 0.62% 3.45% 4.03% 0.00% 4.04% 2.99% 1.68% 1.19% 1.97%


dentist's office or dental clinic? 1 42.86% 56.79% 43.10% 41.94% 56.52% 35.35% 50.00% 52.94% 56.55% 49.26%








dentist's office or dental clinic? 5 to 9 7.14% 6.17% 5.75% 6.45% 2.17% 3.03% 3.73% 9.24% 2.38% 5.02%


dentist's office or dental clinic? 10 or more 1.02% 1.85% 0.57% 0.00% 0.72% 1.01% 2.24% 0.84% 0.00% 0.90%

Satisfaction with Your Dental Care (0 Worst dental care

possible) 3.19% 1.26% 1.22% 1.75% 0.75% 1.14% 0.78% 5.36% 3.11% 1.99%

Satisfaction with Your Dental Care (1 out of 10 Rating) 1.06% 0.63% 0.61% 0.00% 0.00% 0.00% 0.00% 1.79% 1.86% 0.69%









Satisfaction with Your Dental Care (10 Best dental care

possible) 38.30% 43.40% 38.41% 40.35% 39.55% 42.05% 34.38% 39.29% 48.45% 40.73%

Survey Section: Your Personal Doctor Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health

Health Partners


United


Weighted

Average

Clear Explanations (Usually or Always) 92.21% 94.28% 90.42% 92.45% 93.87% 91.57% 90.41% 90.69% 93.33% 92.26%

Personal Doctor Listens Carefully (Usually or Always) 89.74% 93.37% 89.78% 91.37% 96.23% 93.22% 91.32% 91.22% 91.88% 92.00%

Respect from Providers (Usually or Always) 91.03% 92.15% 92.33% 93.12% 95.71% 94.86% 92.69% 89.76% 91.64% 92.52%

Doctor Spends Enough Time With You (Usually or Always) 90.45% 90.85% 89.71% 88.81% 90.52% 89.33% 89.59% 85.29% 90.72% 89.61%

Doctor Informed and Up to Date on Your Care (Usually or

Always) 82.42% 82.95% 81.37% 86.63% 86.15% 85.98% 85.71% 86.11% 85.71% 84.63%

Satisfaction With Personal Doctor (Rating of 8 to 10) 73.46% 83.00% 79.36% 79.52% 82.82% 83.56% 81.75% 80.80% 83.64% 81.17%

Survey Section: Getting Health Care from Specialists Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health

Health Partners


United


Weighted

Average

Getting Appointment With Specialist (Usually or Always) 80.53% 85.84% 79.73% 84.86% 80.00% 85.95% 80.92% 76.92% 89.08% 83.14%

Satisfaction With Specialist (Rating of 8 to 10) 77.76% 83.56% 81.34% 85.00% 82.47% 85.96% 82.98% 80.17% 80.00% 82.18%

Survey Section: Your Health Plan Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health

Health Partners


United


Weighted

Average

Understanding Written or Internet Materials (Usually or

Always) 57.81% 78.79% 68.04% 76.00% 77.27% 61.67% 81.33% 76.19% 69.90% 72.06%

Getting Needed Information (Usually or Always) 76.00% 89.82% 83.44% 88.57% 82.95% 82.73% 84.85% 82.08% 87.10% 84.96%

Courteous Treatment by Staff (Usually or Always) 93.33% 97.01% 95.39% 92.14% 94.32% 92.73% 94.70% 94.29% 94.19% 94.40%

Health Plan Forms Easy to Fill Out (Usually or Always) 95.02% 96.00% 94.20% 95.13% 96.88% 95.62% 92.31% 95.68% 95.18% 95.11%

Satisfaction with Health Plan (Rating of 8 to 10) 69.26% 81.11% 80.71% 77.50% 81.72% 81.61% 83.39% 72.90% 82.36% 79.32%

Survey Section: About You Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health

Health Partners


United


Weighted

Average

Overall Health (Very Good or Excellent) 35.14% 28.57% 23.88% 28.14% 35.23% 31.94% 31.68% 35.14% 30.18% 30.53%

Overall Mental or Emotional Health (Very Good or Excellent) 44.36% 34.29% 34.98% 32.67% 43.62% 36.02% 41.64% 38.22% 37.20% 37.56%

Had a Flu Shot (Yes) 33.70% 38.67% 41.11% 44.91% 38.10% 48.28% 39.34% 39.09% 38.88% 40.18%

Frequency of Smoking (Some Days or Everyday) 39.71% 41.72% 35.83% 44.19% 31.42% 35.38% 29.35% 31.73% 38.07% 36.91%

Advised to Quit Smoking (Usually or Always) 53.21% 50.81% 54.61% 59.30% 50.00% 56.04% 47.78% 57.45% 55.21% 54.12%

Discussed Smoking Cessation Medications (Usually or

Always) 23.85% 24.32% 31.58% 34.10% 34.07% 36.26% 28.89% 28.57% 29.02% 29.79%

Discussed Smoking Cessation Methods and Strategies

(Usually or Always) 22.94% 21.62% 25.66% 27.75% 33.70% 24.44% 26.44% 25.81% 20.83% 24.89%

Survey Section: About You Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health

Health Partners


United


Weighted

Average

Age X X X X X X X X X X

Gender (Male) 48.38% 38.90% 34.66% 41.00% 32.66% 47.13% 48.88% 43.91% 37.99% 40.80%

Education Level X X X X X X X X X X

Hispanic or Latino Origin or Descent (Distribution of

Hispanics) 7.01% 9.55% 27.55% 11.20% 7.51% 32.79% 7.97% 8.82% 4.04% 12.46%

Racial Distribution X X X X X X X X X X

Note: The symbol X indicates that the measure cannot be reported as a single rate. 1Rates in red font are less than the weighted average for the measure and may appear equal to weighted averages due to rounding.

®️2018 Child CAHPS Rate Chart by Survey Section

Survey Section: Your Child's Health Care in the Last Six

Months Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

Urgent Care as Soon as Necessary (Usually or Always) 92.76% 94.74% 91.41% 91.34% 92.75% 85.58% 90.09% 88.24% 95.52% 91.73%

Appointment for Routine Care When Needed (Usually or

Always) 90.48% 90.16% 87.77% 93.00% 92.06% 83.33% 83.39% 86.16% 93.26% 88.89%

Doctor's Office or Clinic (One or More Visits) 80.37% 79.78% 79.60% 78.90% 82.20% 76.85% 77.29% 78.21% 80.32% 79.33%

Talk About Preventing Illness (Yes) 72.00% 76.63% 69.87% 69.44% 65.97% 66.39% 69.08% 72.93% 70.43% 70.52%

Talk About the Reasons You Might Want Your Child To Take a

Medicine (Yes) 92.94% 95.24% 8.79% 93.10% 93.33% 83.93% 89.39% 89.15% 92.54% 91.27%

Talk About the Reasons You Might Not Want Your Child To

Take a Medicine (Yes) 67.44% 66.35% 59.05% 59.30% 68.89% 51.79% 56.06% 69.77% 72.93% 64.91%

Asked About Best Choice for Your Child Regarding Medications

(Yes) 83.72% 77.88% 67.92% 80.95% 75.56% 73.21% 72.73% 82.81% 81.95% 77.96%

Satisfaction with Child's Health Care (Rating of 8 to 10) 82.49% 86.21% 85.58% 81.50% 83.68% 83.12% 84.17% 85.21% 88.00% 84.69%

Getting Care Your Child Needs (Usually or Always) 88.29% 89.35% 89.21% 89.37% 91.67% 82.70% 88.03% 89.53% 92.19% 88.91%

In the last 6 months, did your child get care from a dentist's

office or dental clinic? Yes 63.34% 58.99% 86.83% 70.59% 71.55% 70.34% 71.85% 66.47% 71.14% 67.76%

In the last 6 months, did your child get care from a dentist's

office or dental clinic? No 36.66% 41.01% 33.17% 29.41% 28.45% 29.66% 28.15% 33.53% 28.86% 32.24%

In the last 6 months, how many times did your child go to a

dentist's office or dental clinic? None 0.85% 1.35% 1.88% 0.93% 0.00% 1.96% 0.82% 2.09% 0.00% 1.08%










dentist's office or dental clinic? 5 to 9 2.55% 1.79% 3.38% 3.70% 2.46% 3.43% 2.86% 2.99% 1.14% 2.63%


dentist's office or dental clinic? 10 or more 1.28% 0.00% 0.00% 0.00% 0.00% 1.47% 0.41% 0.60% 0.29% 0.43%

Satisfaction with Child's Dental Care (0 Worst dental care

possible) 0.88% 0.94% 0.40% 0.49% 1.26% 1.55% 0.00% 0.00% 1.18% 0.72%

Satisfaction with Child's Dental Care (1 out of 10 Rating) 0.44% 0.00% 0.40% 0.98% 0.84% 1.04% 0.00% 0.00% 0.30% 0.40%


Survey Section: Your Child's Health Care in the Last Six

Months

(Continued)

Health Plan

Weighted


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Average








Satisfaction with Child's Dental Care (10 Best dental care

possible) 51.77% 47.42% 52.78% 47.32% 57.56% 53.89% 52.30% 49.06% 51.78% 51.53%

Which of the following would help your child see the dentist

more often? Choose all that apply (Help with transportation to

the dentist)

16.28% 10.15% 8.81% 14.29% 8.08% 23.42% 13.92% 15.23% 15.22% 14.12%


more often? Choose all that apply (Reminders to visit the

dentist)

45.74% 19.80% 24.67% 34.86% 28.28% 58.11% 41.24% 34.98% 36.23% 36.38%


more often? Choose all that apply (More dentists to choose

from)

56.59% 48.22% 32.16% 52.00% 51.01% 27.93% 21.65% 37.04% 46.38% 41.61%


more often? Choose all that apply (More convenient office

hours)

41.09% 16.24% 19.38% 24.57% 25.76% 39.64% 28.35% 20.99% 25.36% 27.14%


more often? Choose all that apply (Dentists that speak my

language)

21.71% 11.68% 17.62% 21.14% 11.11% 33.78% 15.98% 12.35% 13.77% 17.69%


more often? Choose all that apply (Help in finding a dentist)

34.88% 22.34% 14.98% 27.43% 21.21% 21.62% 13.92% 20.99% 22.10% 22.36%


more often? Choose all that apply (Better communication about

benefits from my child's health plan)

32.17% 13.20% 11.45% 17.14% 21.21% 36.04% 18.56% 16.87% 23.91% 21.61%


more often? Choose all that apply (Education about good dental

care)

27.52% 10.15% 6.61% 12.00% 14.14% 37.39% 20.10% 18.52% 14.13% 18.14%


more often? Choose all that apply (None of the above. My child

sees the dentist as often as I like)

59.29% 45.28% 40.58% 52.26% 54.05% 52.01% 39.56% 50.31% 60.81% 50.71%


more often? Choose all that apply (Other (write in)

18.22% 26.90% 22.03% 12.57% 24.24% 13.96% 16.49% 15.64% 28.99% 20.15%

Survey Section: Your Child's Personal Doctor Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Average

Weighted

Clear Explanations Given to Survey Respondent (Usually or

Always) 97.13% 96.52% 95.74% 96.83% 96.68% 90.87% 94.07% 91.40% 96.72% 95.10%

Attentiveness of Providers (Usually or Always) 96.04% 96.86% 95.00% 96.35% 95.93% 90341.00% 95.34% 94.05% 98.10% 95.49%

Respect from Providers (Usually or Always) 97.49% 97.21% 96.80% 97.26% 98.15% 91.28% 97.03% 95.95% 97.29% 96.60%

Clear Explanations Given to Child (Usually or Always) 91.95% 94.05% 94.57% 90.51% 94.05% 91.43% 94.20% 93.20% 95.36% 93.40%

Doctor Spends Enough Time With Your Child (Usually or

Always) 91.34% 93.03% 91.10% 93.15% 94.44% 82.11% 88.03% 89.52% 94.25% 91.04%

Child's Feeling, Growing and Behaving (Yes) 91.07% 90.28% 86.83% 87.67% 90.37% 87.56% 89.83% 91.13% 91.26% 89.76%

Doctor Informed and Up to Date on Your Child's Care (Usually

or Always) 86.92% 83.08% 82.39% 89.32% 87.41% 77.88% 83.02% 81.71% 82.56% 83.71%

Satisfaction with Personal Doctor (Rating of 8 to 10) 89.53% 90.66% 87.03% 87.59% 88.31% 86.72% 84.97% 87.20% 90.58% 88.22%

Survey Section: Getting Health Care from Specialists Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

Getting Appointment with Specialist For Your Child (Usually or

Always) 78.95% 72.82% 84.21% 81.11% 80.58% 81.48% 82.76% 79.22% 75.00% 79.18%

Satisfaction with Specialist (Rating of 8 to 10) 88.37% 84.62% 83.64% 79.27% 83.87% 89.04% 84.52% 87.86% 85.09% 85.22%

Survey Section: Your Child's Health Plan Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Average

Weighted

Getting Needed Information (Usually or Always) 83.04% 86.40% 90.85% 85.22% 87.23% 77.86% 81.97% 85.71% 80.27% 84.26%

Courteous Treatment by Staff (Usually or Always) 96.36% 94.44% 97.18% 92.17% 93.62% 93.13% 95.04% 94.01% 96.60% 94.80%

Health Plan Forms Easy to Fill Out (Usually or Always) 85.68% 96.50% 95.65% 94.43% 96.55% 92.83% 94.64% 95.55% 97.38% 95.61%

Satisfaction with Child's Health Plan (Rating of 8 to 10) 80.90% 88.19% 88.81% 84.45% 87.75% 87.86% 87.35% 83.56% 89.64% 86.50%

Survey Section: About Your Child and You Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Average

Weighted

Overall Health (Very Good or Excellent) 77.75% 73.56% 71.96% 75.30% 77.25% 68.37% 74.49% 71.32% 76.28% 74.05%

Overall Mental or Emotional Health (Very Good or Excellent) 73.81% 69.29% 66.09% 61.86% 69.03% 66.56% 68.51% 64.42% 63.35% 66.80%

Child's Age X X X X X X X X X X

Child's Gender (Male) 50.79% 53.79% 48.51% 54.38% 56.18% 56.17% 47.25% 53.86% 56.94% 53.19%

Hispanic or Latino Origin or Descent (Distribution of Hispanics) 16.62% 19.74% 44.50% 17.79% 12.22% 40.73% 20.06% 13.81% 11.90% 12.39%

Racial Distribution X X X X X X X X X X

Survey Respondent's Age X X X X X X X X X X

Survey Respondent's Gender (Male) 13.30% 13.68% 10.70% 14.38% 9.30% 9.33% 14.58% 13.81% 11.90% 12.39%

Survey Respondent's Education Level X X X X X X X X X X

Relation to Child X X X X X X X X X X

Note: The symbol X indicates that the measure cannot be reported as a single rate. 1Rates in red font are less than the weighted average for the measure and may appear equal to weighted averages due to rounding.

2018 Pennsylvania Performance Measure Rate Chart by Domain

Domain: Children Dental Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

nta

l

Annual Dental Visits for Members with Developmental

Disabilities, Ages 2 to 21 61.09% 66.53% 67.97% 63.82% 55.06% 64.74% 68.67% 56.24% 55.57% 62.50%

De

Dental Sealants for 6 to 9 year olds at elevated carries risk 25.21% 24.98% 22.43% 23.78% 38.44% 23.82% 22.79% 21.27% 23.67% 24.39%

Domain: Preventive Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

Follow-Up Care for Children Prescribed Attention-

Deficit/Hyperactivity Disorder Medication: Continuation and

Maintenance Phase

33.49% 40.50% 27.47% 60.06% 42.67% 67.89% 25.09% 66.29% 58.08% 48.46%

Reducing Potentially Preventable Readmissions1 11.42% 6.55% 7.87% 9.50% 9.60% 11.63% 12.60% 10.93% 8.66% 10.35%

Pre

ve

nti

ve

Adherence to Antipsychotic Medications for Individuals

with Schizophrenia 59.71% 76.76% 69.61% 68.74% 75.98% 62.86% 70.20% 66.91% 74.35% 69.00%

Developmental Screening in the First Three Years of Life

(turned 1, 2 or 3 during measurement year) - Use of CPT

code 96110 limited or 96111 extended4

58.81% 57.31% 47.79% 52.82% 62.28% 46.02% 53.15% 55.16% 67.54% 55.84%

Contraceptive Care for Postpartum Women Ages 15-44

(Numerator 1 Most or moderately effective contraception 3

days)4

11.77% 12.91% 14.59% 11.96% 13.50% 17.24% 17.67% 5.24% 10.49% 13.11%


(Numerator 2 Most or moderately effective contraception

60 days)4

39.05% 45.84% 50.30% 42.25% 36.18% 51.51% 46.05% 28.27% 22.32% 39.17%


(Numerator 3 Long acting reversible method of

contraception LARC 3 days)4

0.95% 0.19% 1.77% 0.92% 0.62% 4.92% 4.41% 1.06% 1.64% 2.19%


(Numerator 4 Long acting reversible method of

contraception LARC 60 days)4

7.86% 7.05% 12.99% 9.89% 6.33% 14.70% 14.77% 9.86% 9.39% 10.93%

Contraceptive Care for All Women Ages 15-44 (Numerator

1 Provision of most or moderately effective contraception)4

27.84% 32.08% 31.14% 30.33% 23.23% 29.38% 30.83% 22.45% 13.87% 25.79%

Contraceptive Care for All Women Ages 15-44 (Numerator

2 Provision of LARC)4 4.90% 5.62% 7.15% 6.10% 4.55% 7.08% 6.43% 5.43% 6.16% 6.07%

Domain: Chronic Conditions Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

Ch

ron

ic C

on

dit

ion

s

Asthma in Older Adults Admission Rate (Ages 40 and

Older) 46.12 56.16 67.23 101.42 270.78 70.04 100.13 77.70 68.03 93.74

Asthma in Younger Adults Admission Rate (Ages 18 - 39) 5.00 4.65 7.39 7.03 3.83 7.75 13.84 6.18 5.37 7.32

Heart Failure Admission Rate (Ages 18 - 64) 9.32 10.25 14.39 23.53 14.05 29.15 27.51 22.19 12.82 19.35

Heart Failure Admission Rate (Ages 65 and Older) 10.73 78.80 11.36 118.87 48.29 70.63 74.34 61.60 101.33 70.24

Diabetes Short-term Complications Admission Rate (Ages

18-64) 8.09 13.48 12.41 25.84 13.13 9.81 20.84 12.76 11.33 14.66

Diabetes Short-term Complications Admission Rate (Ages

65 and Older) 0.00 0.00 0.00 9.14 16.10 0.00 0.00 0.00 0.00 1.85

Domain: Pregnant Women Health Plan


Health

AmeriHealth

Caritas

Northeast

AmeriHealth

Caritas

Pennsylvania


Health Plan

Health Partners


United


Weighted

Average

Pre

gn

an

t W

om

en

Elective Delivery 4.05% 15.50% 11.74% 2.47% 3.27% 1.51% 5.64% 4.48% 2.73% 4.69%

Percentage of Live Births Weighing < 2,500 Grams 10.17% 9.38% 9.46% 10.43% 7.16% 10.04% 10.52% 10.18% 10.21% 9.89%

Cesarean Rate for Nulliparous Singleton Vertex 24.14% 24.18% 21.11% 25.81% 22.05% 23.15% 23.39% 20.04% 25.83% 23.60%

Prenatal Screening for Smoking During a Prenatal Visit 73.39% 69.95% 76.92% 66.26% 89.85% 94.84% 90.86% 86.58% 96.54% 82.82%

Counseling/Advice for Smokers During a Prenatal Visit 74.75% 90.29% 92.59% 81.11% 88.14% 72.86% 90.16% 100.00% 85.27% 86.06%

Prenatal Screening for Environmental Tobacco Exposure

During a Prenatal Visit 39.53% 36.21% 38.46% 18.23% 52.97% 72.73% 57.78% 47.63% 55.06% 46.54%

Counseling/Advice for Environmental Tobacco Exposure

During a Prenatal Visit 82.14% 73.77% 58.54% 59.09% 78.08% 80.77% 70.73% 100.00% 87.80% 78.54%

Pregnant Smokers Who Quit During Their Pregnancy 8.08% 8.74% 11.11% 7.78% 15.97% 21.74% 13.33% 5.90% 9.30% 9.95%

Prenatal Depression Screening 47.29% 68.23% 71.22% 45.07% 84.75% 93.12% 83.70% 76.05% 82.72% 72.50%

Prenatal Depression Screening: Positive for Depression 22.40% 20.94% 23.00% 30.60% 21.65% 15.57% 12.98% 21.45% 20.00% 20.15%

Prenatal Depression Screening: Positive for Depression

and Evaluation,

Treatment or Referral

60.98% 74.14% 75.76% 71.43% 61.97% 84.75% 86.36% 79.03% 70.15% 73.66%

Postpartum Depression Screening 46.65% 59.86% 66.99% 74.83% 84.27% 79.41% 60.83% 90.80% 97.30% 73.36%

Postpartum Depression Screening: Positive for

Depression 19.72% 10.40% 15.12% 17.26% 18.67% 9.63% 13.17% 14.98% 18.75% 15.25%

Postpartum Depression Screening: Positive for

Depression and Evaluation, Treatment or Referral 60.71% 100.00% 96.77% 84.62% 76.19% 96.15% 96.30% 88.24% 92.59% 87.29%

Prenatal Screening Based on Use of Validated Depression

Tool 25.32% 34.98% 37.47% 25.86% 47.80% 67.57% 43.46% 33.16% 45.68% 40.24%

Postpartum Screening Based on Use of Validated

Depression Tool 29.37% 38.75% 51.96% 52.98% 56.55% 70.00% 44.51% 73.60% 78.04% 54.96%

Maternity Risk Factor Assessment - Alcohol Use 67.70% 69.70% 72.46% 46.80% 91.83% 94.59% 89.63% 83.68% 95.06% 79.07%

Maternity Risk Factor Assessment - Drug Use (Street) 66.22% 69.21% 72.70% 48.03% 95.79% 93.86% 87.65% 82.37% 93.33% 79.05%

Maternity Risk Factor Assessment - Drug Use

(Prescription) 73.13% 70.44% 73.70% 67.73% 96.29% 95.09% 89.14% 88.68% 97.78% 83.57%

Maternity Risk Factor Assessment - Intimate Partner

Violence 45.74% 47.78% 50.62% 24.38% 54.70% 77.15% 73.33% 63.16% 65.93% 55.87%

Frequency of Ongoing Prenatal Care, 81+ Percent of

Recommended Visits3 68.17% 71.53% 70.07% 72.99% 79.08% 76.89% 60.10% 63.99% 72.51% 70.60%

1 A lower rate indicates better performance for these measures.

2 Rates in red font are less than the weighted average for the measure and may appear equal to weighted averages due to rounding.

3 FPC is a first year measure for PAPM in 2018.

4 Contraception Measures CCP and CCW are first year measures.

Documents

2018 HEDIS Rate Chart by HEDIS - dhs.pa.gov